When I see new clients in my psychotherapy practice, I explain that to protect their confidentiality, if I see them out in public I will not approach them. If they choose to say hello, that is their choice and I’m happy to see them. The response to this is varied. There is no incorrect response to this situation, it is a client’s decision to make and I respect their choice. I have also had many clients who were very comfortable to engage in therapy, but tell me that they can’t share it with others. Whatever the reason, some clients just want to keep this part of their lives private.
I have noticed over the years, however, that more and more clients have either started therapy because their friends or family shared how helpful it was for them, or that clients are more willing to disclose to others that they are in therapy. This is the trend that I hope continues upward, and it mirrors our cultural shift toward ending the stigma around mental health. Except that when it comes to eliminating the stigma, we’re doing it all wrong.
Let me explain what I mean. In news stories and talk show segments, there is an ongoing effort to create stories of innovative programs, success stories, and inspirational pieces to celebrate the treatment of mental health. The problem arises in how these stories are introduced. You’ll hear commentary such as “in our month-long series about ending the stigma of mental health, we’ll bring you the story of…” or “we need more people doing things like this to end the stigma of mental health.”
A Better Way to Reduce Stigma?
To be clear, I am not criticizing the movement toward ending the stigma or the people making an effort to further this cause. Mental health is my profession and my passion, and I am so happy to see so many people fighting to bring awareness to treatment options and resources. But imagine this: You tell a friend that you have been experiencing heart palpitations so you are going to see a cardiologist. Your friend pats you on the shoulder, gives you a solemn look and says “Hey, I think that’s great. Thanks for sharing that with me, there is totally no shame in that.” We would never do this around medical issues, but this is exactly what we are doing with mental health. Pointing out that there is a stigma around mental health, while at the same time saying we need to remove the stigma simply reinforces the fact that it carries with it… a stigma; it pairs the two together.
So what is the solution here? Well, the good news is we are already headed in the right direction; we just need to make a small adjustment. We need to stop attaching the word stigma to every story and situation – simply stop saying it.
When someone tells you they are going to therapy, do not – I repeat – do not do the head tilt with a sympathetic nod. Had they said dentist instead of therapist, how would you react? Think of questions or comments that show support but without any indication of shame or stigma. “I hope you find him/her helpful!” “I’ll bet you will feel so much better after you are able to talk about some things.” “Let me know if you need me to watch the kids while you’re at your appointment.” “Therapy was great for me/my sister/my husband/my friend, I hope you have a great experience.” The more you normalize the experience, the more normal it becomes.
The reasons that people seek therapy vary in severity. So the response to someone’s announcement of being in therapy will need to be varied as well. There is a big difference in someone sharing that they are having a tough time in their relationship or that anxiety about world events is starting to get the best of them and someone who is struggling with a severe mental health diagnosis or suffering a loss or trauma. For disclosures of a more somber nature, it is such a gift to be able to offer appreciation and support. “I love that you shared this with me, I am so proud of you,” “I would love to hear about what you learn in therapy and how it’s helping you,” “If you’re comfortable, I would love to know what new skills you learn and how I can support you in putting them into practice.” Leaving any mention of stigma out is still appropriate, but the level of sensitivity can be adjusted as needed. If someone is sharing this information with you, they likely trust you and are looking to you for feedback on their journey.
The decision to share with others that you are in therapy is a personal one. While it helps contribute to the notion that being in therapy is common and a normal part of working through the issues of everyday life, it can also leave you feeling vulnerable. There is always a chance that well-meaning friends and family will tell you what your real problem is, or tell you what you should be doing instead. Perhaps sharing that you are seeking help is interpreted that you are asking anyone and everyone for help. Not everyone feels comfortable pushing back a bit and asserting that this was not an invitation to pry into your life, but simply a moment of trying to connect and share. My hope is that as you’ve been reading so far, you are excited at the idea of finding ways to move this agenda forward. But I do want to give you the chance to reflect on whether or not sharing your own therapy experience is the right move for you.
Normalizing the Conversation
Whether it’s celebrities on social media or during interviews, or everyday people in conversation, my heart sings when I hear people mention mental health as the least important part of a conversation. “I heard the coolest thing from my therapist last week…” “I need to remember to tell my therapist about the conversation I had about…” “The job and school situation is really doing a number on my anxiety, I can’t wait to work some of that out in therapy.” The more that the concepts of therapy and mental health become a part of our every day vernacular, the more normalized it becomes. And, wait for it… less stigmatized.
The trend toward mental health awareness and acceptance is truly a wonderful thing. I don’t want to take away from any person or organization that is advancing this effort. My goal here is to be able to dive deeper into the impact that the current language around the movement is having. Making a slight turn away from the words, spoken and unspoken, that point to a stigma can have a profound effect. And the good news is that it is a simple and tangible solution. Support those who share their desire to begin therapy by showing them your enthusiasm and understanding of their journey, and doing so without a hint of pity. Whether or not you share any of your own experiences with therapy, find ways to make mental health talk a part of everyday conversations. If we have to peel back the stigma label every time we speak about it, we never really shake off that shadow.
With 2020 being the year of unprecedented stresses around the pandemic, school issues, civil unrest, job changes or losses, and countless other stresses, it seems like the perfect time to put many of these ideas into practice. These issues can cause new reasons for people to seek therapy or exacerbate existing conditions. Regardless, what a perfect time to begin to shift our focus to wonder who would not benefit from therapy right now!
So what about people who are reluctant to go to therapy? Or my clients who don’t want to share that they are in therapy? This is valid, but what if, over time, those around them start sharing how therapy has helped their friend, co-worker, barista, or brother-in-law. What if they learn that one of their favorite book club members struggles with bipolar disorder? What if their favorite actor speaks about the challenge of a mental health diagnosis and how the inspiration to do their latest movie came from their therapist? They may start to realize that mental health and its treatment are very commonplace, and that they need to make a change in their approach to this topic.
If we become a society that speaks openly about mental health with a positive spin, without any hint of the word stigma, then we become part of the solution. It is in this way that we become people who truly eliminate the stigma and shame around mental health.
–Denver mom Debi Smith-Racanelli has two advanced degrees in Psychology, and is a passionate advocate of parenting education.
Author: Mile High Mamas
